Most common D1384 code reviews : Typical crown benefits for the replacement of an existing crown range from five to seven years before a replacement crown payment will be permitted, Removal of implant; superficial (e.g., buried wire, pin, or rod) (Separate procedure) or Accession of tissue, gross and microscopic examination, preparation and transmission of written report.
Prophylaxis-adult. For payment purposes, the distinction between the adult and child dentition is determined by contract. Any fee in excess is Disallowed and not chargeable to the Patient. In the absence of group contract language regarding age, a person age fourteen (14) and older is considered an adult for benefit determination purposes of a prophylaxis-adult.
A patient encounter with a practitioner whose opinion or advice regarding evaluation and/or management of specific problem; may be requested by another practitioner or D1384 appropriate source The consultation includes an oral evaluation he consulted practitioner may initiate diagnostic and/or therapeutic services.
A patient presents with a carious pulp exposure of tooth T There is no succedaneous tooth #29 present on a radiograph The roots of this tooth are of adequate length to allow normal function Endodontic treatment is requested on tooth T in order to maintain this tooth in the arch and facilitate the placement of a functional, final restoration. Root canal treatment is performed on the tooth, and the canals are filled with gutta-percha. A temporary restoration is placed, and the patient is referred back to the referring dentist for a final restoration.
Pin retention-per tooth, in addition to restoration is a benefit, once per tooth, when necessary on permanent tooth and when completed at the same appointment as the restoration. Additional pins on the same tooth are Disallowed as a component of the initial pin placement. The fee for pin retention when billed In Conjunction With a buildup is Disallowed as a component of the buildup procedure.
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